YOUTHCARE PEDIATRICS (NPI# 1275841488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275841488 |
| Entity Type | Organization |
| Organization Name | YOUTHCARE PEDIATRICS |
| Practice Address |
212 Midway Medical Park Bristol TN 37620-1664 |
| Practice Telephone | 4239684007 |
| Practice Fax Number | 4236522590 |
| Mailing Telephone | 4239684007 |
| Mailing Fax Number | 4236522590 |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-09-22 |
| Authorized Official Name | DR. THOMAS EDWARD MITORAJ (OWNER) |
| Authorized Official Telephone | 4239684007 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 021345 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3060577 | 05 | |
| TN | BLUE CROSS TN | 0123498 | 01 |
| VA | ANTHEM | 042029 | 01 |
| VA | 006746080 | 05 |
| Street Address |
212 MIDWAY MEDICAL PARK |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-1664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255381752 | Thomas E Mitoraj | Pediatrics | 212 Midway Medical Park, Bristol, TN 37620-1664 | 2006-05-12 |
| 1003122755 | Kelly Carter Simcox | Nurse Practitioner | 212 Midway Medical Park, Bristol, TN 37620-1664 | 2010-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093760902 | Internal Medicine and Pediatric Assoc of Bristol | Pediatrics | 350 Steeles Road, Bristol, TN 37620-9532 | 2006-05-23 |
| 1255381752 | Thomas E Mitoraj | Pediatrics | 212 Midway Medical Park, Bristol, TN 37620-1664 | 2006-05-12 |
| 1114925195 | Susan Glasser | Pediatrics | 43 Enterprise Dr, Bristol, CT 06010-7457 | 2005-07-13 |
| 1952309924 | Lisa Menillo | Pediatrics | 1301 Farmington Ave, Bristol, CT 06010-4776 | 2005-07-13 |
| 1811994981 | John Richard Hovious IIi | Pediatrics | 109 Meadow View Road, Suite 7, Bristol, TN 37620-1661 | 2005-07-05 |
| 1902357163 | The Pediatric Care Center, LLC | Pediatrics | 1301 Farmington Ave, Bristol, CT 06010-4776 | 2016-10-21 |
| 1164765871 | Cassie Brooks Hudson | Pediatrics | 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 | 2013-04-01 |
| 1649460874 | Carla Elaine Bystricky | Pediatrics | 41 Brewster Rd, Bristol, CT 06010 | 2007-07-25 |
| 1821209578 | Jessica D Hommel | Pediatrics | 320 Steeles Rd, Bristol, TN 37620-9532 | 2007-05-24 |
| 1043429806 | Bristol Hospital Multi-specialty Group, Inc. | Pediatrics | 44 Brewster Road, Bristol, CT 06010 | 2007-05-21 |
| Find all providers in BRISTOL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.